What is Healthy NY?
Healthy NY is a state subsidized plan which partners with leading insurance companies, including CDPHP, MVP, Empire BC/BS, and more to provide comprehensive and affordable health insurance to small businesses.
Eligibility
To participate in Healthy NY, a small business must meet the following criteria:
- Must be located within NYS and have had 1-50 Full-Time Equivalent (FTE) employees over the previous calendar year.
- At least 30% of the employees must earn $45,450 or less in annual wages. The wage level is adjusted annually for inflation.
- Must not have provided group health insurance coverage to its employees within the last 12 months. A business is considered to have provided health insurance if the business has arranged for comprehensive coverage that includes both hospital and medical coverage and contributed at least $50 per employee per month towards health insurance ($75 if the business is located in the Bronx, Kings, Nassau, New York, Orange, Putnam, Queens, Richmond, Rockland, Suffolk or Westchester counties).
- The business arranged for health insurance coverage for employees but did not contribute more than the previously noted amounts.
- The business arranged for health insurance coverage for employees but it was not comprehensive (i.e., only medical benefits or only hospital benefits but not both).
- Individual employees had insurance coverage through other sources, such as individually-purchased coverage, a public program, COBRA from prior employment or a spouse’s job.
- The business owner has coverage for himself or herself but did not provide the coverage to employees.
- The business provided insurance coverage to one or more classes of employees and now wants to provide coverage to additional classes of employees. Classes of employees may be based on wages, method of payment (e.g., hourly vs. salaried), job duties or job location.
- 50% of the eligible employees will participate in the program and at least one participant earns annual wages of $45,450 (adjusted annually) or less. An employer may count employees who have health insurance coverage through another source, such as a spouse or government program, towards the 50% participation requirement.
- The employer will contribute at least 50% of the premium.
- At least one eligible employee earning $45,450* or less enrolls.
- The employer will offer Healthy NY to all employees who are working 20 or more hours per week and earning $45,450 (adjusted annually) or less. If the business meets the the four criteria above.